Specialist, RCM

Mayfield Clinic, Inc.; Cincinnati (OH); On-site; USD 42,000 - 62,000; Full time

Job summary

Mayfield Clinic, Inc. is seeking a remittance posting specialist to join our Revenue Cycle Management team in Cincinnati. You will process insurance takeback requests, refunds, and zero-pay remittances, while supporting timely cash flow.

Ideal candidates have insurance claims/remittance posting experience, strong attention to detail, and the ability to learn quickly in a changing environment. High school diploma and healthcare experience are required.

Qualifications

• High School Diploma required.
• Two years' experience in healthcare administration/revenue cycle.
• CRCR Certification preferred.

Responsibilities

• Follow up on insurance claims; expedite cash flow and maximize reimbursement.
• Resolve denials and takeback requests with payers.
• Post payments and ensure accurate remittance posting.
• Research and respond to payer questions in a timely manner.
• Maintain documentation in the practice management system.
• Prioritize claims by aging and dollars outstanding.
• Contribute to a team environment and perform other duties as assigned.

Skills

Customer service

Empathy

Problem solving

Prioritization

Communication

Calm under pressure

Diplomacy

Teamwork

Computer proficiency

Independent worker

Education

High School Diploma

2 years healthcare admin/revenue cycle experience

CRCR Certification preferred

Job description

Career Opportunities with Mayfield Clinic

Current job opportunities are posted here as they become available.

This Specialist will join the remittance posting teamand be responsible for processing insurance company takeback requests, refunds, zero-pay remittances, and other tasks related to payment and remittance posting. The Revenue Cycle Management (RCM) team is looking forsomeone with insurance claims and/or remittance posting experience, plus critical thinking skills, attention to detail, and the ability to learn quickly and adapt to a changing environment.

Education/Experience:

• High School Diploma required
• Two years' experience in healthcare administration/revenue cycle
• CRCR Certification preferred

Skills:

• Demonstrates excellent customer service
• Ability to convey empathy
• Strong problem-solving, problem-prevention, and decision-making skills
• Ability to manage and prioritize multiple tasks in a fast-paced environment
• Excellent oral and written communication skills
• Ability to maintain composure and restore calm in a stressful situation
• Uses good judgment and diplomacy when dealing with others
• Desire and ability to work in a team environment
• Computer proficient with the ability to learn multiple software applications
• Ability to work with minimal supervision

Primary Responsibilities:

The purpose of this position is to execute follow-up actions on insurance claims; expedite positive cash flow, maximize reimbursement, and resolve claims denials and issues with payers in the assigned area of the Revenue Cycle claims process.

Essential Functions:

• Help develop &maintain a corporate culture that supports the mission and values of Mayfield Clinic
• Follow up on submitted electronic & hard copy claims in an accurate, timely manner; submit appeals, make corrections to overturn denials, post payments, & process takeback requests as required.
• Make all necessary corrections to claims that do not pass billing edits/payer requirements & resubmit to payers.
• Contact payers regarding unpaid claims. Research and/or ensure that questions and requests for information are addressed in a timely & professional manner to ensure resolution & reimbursement.
• Ensure timely & accurate posting of remittance advice information & follow up as needed to ensure full, expected reimbursement for services provided.
• Maintain documentation and update our practice management system for appropriate claims submission & other pertinent information to identify action taken.
• Make necessary adjustments as appropriately required by plan reimbursement & company policy.
• Prioritize claims based on aging and outstanding dollar amounts or as directed by management.
• Research & initiate requests for refunds for accounts with credit balances.
• Answer & initiate phone inquiries regarding bills, charges, claims, and account status.
• Update data in the practice management system as required.
• Contribute to the team environment by performing other duties as assigned.

Physical Requirements:

• Hand Movement, including repetitive motions, grasping, holding, and finger dexterity. Reading, Writing,and Hand-Eye Coordination. Vision, including color distinction, and visual inspection. Hearing, talking, sitting, lifting up to 10 pounds, bending, reaching

Mayfield Clinic Mission:

To provide the best neurological care for our patients through:

• Superior clinical outcomes
• Education and research

Mayfield Clinic Values:

All associates who are affiliated with the Mayfield Clinic must agree to use these values as a basis fortheir employment, and recognize that they are part of the associate’s annual Performance Review andDevelopment Plan:

• Integrity:We commit to honest and ethical behavior in all of our endeavors and interactions.
• Excellence: We commit to the highest level of performance and continuous improvement.
• Respect: We embrace the importance of all individuals & value their diverse backgrounds, skills & contributions.
• Compassion: We commit to being compassionate and empathetic in all of our interactions.
• Collaboration: We embrace teamwork, mentoring, cooperation, sharing of expertise, & empowerment.